Provider Demographics
NPI:1073398004
Name:LIM, AARON C (PHD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:C
Last Name:LIM
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:482 N ROSEMEAD BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3053
Mailing Address - Country:US
Mailing Address - Phone:310-564-6278
Mailing Address - Fax:
Practice Address - Street 1:482 N ROSEMEAD BLVD STE 207
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3053
Practice Address - Country:US
Practice Address - Phone:310-564-6278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY34307103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical